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Purpose: dosimetric comparison of high dose rate interstitial brachytherapy (HDR) and irradiation with electrons for radiation boost after whole-breast irradiation.
Material and methods: in 62 patients with рТ1N0М0-рТ2№М0 breast cancer we used HDR brachytherapy for delivering boost to tumor bed. In all cases insertion of plastic needles was performed under CT control with subsequent 3D planning. Pre-insertion CT were used for 3D planning of boost delivery with electrons.
Results: Boost delivery with HDR brachytherapy had several important advantages when compared with boost with electrons. HDR brachytherapy demonstrated more accurate irradiation of tumor bed: D90 HDR - 93,1 % (69,1 % - 118 %), D90 electrons - 86,2 % (47,6 % - 104,1 %). Boost delivery with HDR brachytherapy help to minimize radiation burden to left main coronary artery - Dmax electrons - 14.8 % (0.2 %-71.8%), Dmax HDR - 5.2 % (0.7 %-14.2 %). Radiation burden to left anterior descending artery is also decreasing: Dmax electrons - 21.9 % (0.8 %-94.1 %), Dmax HDR - 10.5 % (1.9 %-31.5 %). Radiation dose absorbed in ip-silateral lung also significantly lower with HDR brachytherapy: Dmed electrons - 6,5 % (0,5 % - 19,3 %), Dmed HDR - 2,3 % (0,8 % - 10,8 %).
Conclusions: the present dosimetric analysis indicated that boost delivery with HDR brachytherapy is more accurate than irradiation with electrons.
References
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